The relationship between liver histology and thyroid function tests in patients with non-alcoholic fatty liver disease (NAFLD)

The relationship between liver histology and thyroid function tests in patients with non-alcoholic fatty liver disease (NAFLD)

Data on the role of hypothyroidism in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis are conflicting, although selective Thyroid Hormone Receptor (THR)-β agonists have been identified as potential therapy in patients with non-alcoholic steatohepatitis (NASH). Theref...

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Published in:PloS one Vol. 16; no. 4; p. e0249614
Main Authors: D'Ambrosio, Roberta, Campi, Irene, Maggioni, Marco, Perbellini, Riccardo, Giammona, Enza, Stucchi, Roberta, Borghi, Marta, Degasperi, Elisabetta, De Silvestri, Annalisa, Persani, Luca, Fugazzola, Laura, Lampertico, Pietro
Format: Journal Article
Language:English
Published: United States Public Library of Science 06-04-2021
Public Library of Science (PLoS)
Subjects:
Autophagy
Biology and Life Sciences
Biopsy
Collagen
Complications and side effects
Diabetes
Diagnosis
Editing
Epidemiology
Fatty acids
Fatty liver
Fibrosis
Gastroenterology
Gluconeogenesis
Hepatology
Histology
Hypertension
Hypothyroidism
Laboratories
Lipids
Lipolysis
Liver
Liver diseases
Low density lipoprotein
Medicine
Medicine and Health Sciences
Metabolic disorders
Mitochondria
Oxidation
Pathophysiology
Patients
Phagocytosis
Physiological aspects
Risk factors
Steatosis
Thyroid
Thyroid gland
Transplantation
Triglycerides
Triiodothyronine
Italy
United States > US
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Summary:Data on the role of hypothyroidism in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis are conflicting, although selective Thyroid Hormone Receptor (THR)-β agonists have been identified as potential therapy in patients with non-alcoholic steatohepatitis (NASH). Therefore, we investigated the association between hypothyroidism and NAFLD histological features potentially associated with progressive liver disease. Between 2014 and 2016, consecutive patients with histologically proven NAFLD and frozen serum available for thyroid function tests assessment were included. NAFLD was staged according to the NAFLD Activity Score (NAS), and fibrosis according to Kleiner. NASH was defined as NAS ≥4, significant fibrosis as F2-F4 and significant steatosis as S2-S3. Thyroid function tests (TFT; TSH, FT3, FT4, rT3), TPO-Ab and Tg-Ab were also assessed. Fifty-two patients were analyzed: median age 54 years, 58% females, LSM 7.8 kPa, 27% diabetics, 14% hypothyroid. At histology, NASH was present in 21 (40%), F2-F4 in 28 (54%) and S2-S3 in 30 (58%) patients. Rates of hypothyroidism were similar independently of the presence of NASH (p = 0.11), significant fibrosis (p = 0.21) or steatosis (p = 0.75). However, hypothyroid patients displayed a higher NAS (p = 0.02) and NASH (p = 0.06) prevalence. At multivariate analysis, TFT were not independently associated with histology. Hypothyroidism was highly prevalent in NAFLD patients, and was associated with increased NAFLD activity, but not with fibrosis and steatosis severity. Thus, thyroid dysfunction might play a direct and/or indirect in the pathogenesis of NAFLD and NASH.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0249614